COPIC Comment: What else can we do to address opioids?

Tuesday, May 01, 2018 12:25 PM

by Ted J. Clarke, MD, Chairman & CEO, COPIC Insurance Company

We have become used to seeing headlines about the devastating impact of opioids, and data continues to highlight the scope and severity of this issue. A recent Colorado Health Institute (CHI) report[1] noted the following:

• Colorado recorded 912 drug overdose deaths in 2016, more than in any previous year.
• That translates to a rate of 16.1 drug overdose deaths for each 100,000 residents, up 83 percent from a rate of 8.8 in 2001.

The report did offer some positive news. Since 2007, overdose deaths in Colorado due to prescription opioids have been leveling off (300 deaths in 2016 versus a high of 338 in 2014). It’s a trend that the report says “is most likely occurring as physicians become more mindful about prescribing opioids.”

Medical providers are shifting their focus from awareness to understanding what approaches are working to address opioids. Like many, COPIC pondered the question of “what else can we do?” We have learned that the most effective contributions draw upon our strengths, reinforce collaboration, and embrace a multi-faceted approach that includes professional education, grant funding, and legislative advocacy.

Education

COPIC has been involved with opioid educational initiatives for more than five years, and we have taken our experience to develop a two-part seminar:

The Opioid Crisis Part I: The Pain That Won’t Go Away—Participants examine guidelines and best practices to safely manage opioids. Specific objectives include:

• Distinguish the specific risks in the medical treatment of pain, including misdiagnosis, overprescribing or under-prescribing, abandonment and diversion.
• Apply prescribing tools in the setting of chronic pain, including risk assessment, opioid agreements and indications for pain specialist consultation.

The Opioid Crisis Part II: Strategies for Reducing the Burden—A review of opioid dose reduction and discontinuation as well as techniques to encourage patient buy-in. Specific objectives include:

• Review candidate selection and standard-of-care monitoring practices for patients taking chronic opioid therapy (COT).
• Learn behavioral strategies to overcome patient resistance and gain comfort with difficult patient interactions around opioid dose changes.
• Master dose reduction schedules and aggressive opioid withdrawal management to promote successful weaning and discontinuation.

In addition, we have a close partnership with the Colorado Consortium for Prescription Drug Abuse Prevention to promote its courses on topics such as CDC guidelines, opioid use disorder recognition, and medication-assisted treatment.

Grant support

In 2017, the COPIC Medical Foundation provided a grant to the Harm Reduction Action Center for medical provider training that facilitates a better understanding of the health care needs of people who inject drugs. This is an example of how COPIC supports organizations that provide a unique perspective on a complex issue through specialized training. Participants learn about contributing factors that lead to opioid addiction and overdoses – valuable knowledge to improve patient treatment.

Legislative advocacy

COPIC’s dedicated team focuses on monitoring legislative bills in Colorado to ensure that medical liability and patient safety concerns are recognized. With opioids, we are strong advocates for the effective use of the state’s Prescription Drug Monitoring Program. Our team also follows interim study committees on opioid and other substance use disorders. These efforts allow us to stay connected at a broader policy level and offer our insight throughout the legislative process.

COPIC is committed to providing ongoing support and provider education as well as working with organizations to address opioids and other complex medical issues. Not only do our efforts focus on sharing best practices to improve outcomes, they also take into account the human aspect of the provider-patient relationship. As the CHI report notes, “Colorado lost 912 people to drug overdoses in 2016. Each person had a story. But each is part of a bigger picture as well.”

1 Death by Drugs Colorado Reaches a Record High for Overdose Fatalities. Again.; www.coloradohealthinstitute.org/research/death-drugs